Download - Epidemiology of Lymphoma in Saudi Arabia
Epidemiology of Lymphoma in Saudi Arabia
Mr.Abdulaziz R. AlanziMedical Student, Al-Imam University
Riyadh – Saudi Arabia
Road Map
Definition
Classification
Risk Factors
Etiology
Prevalence – World Wide
Prevalence – Saudi Arabia
References
1. Harrison’s Principles of Internal Medicine Book 17th edition2. Kumar et al: Robbins Basic Pathology Book 8th edition3. World Health Organization (WHO) 4. Medscape Reference5. Surveillance Epidemiology and End Results (SEER)6. Cancer Center, University of Kansas7. Right Diagnosis
Definition
•Malignant tumors of lymphoid tissue, characterized by the abnormal proliferation of B or T cells in the lymphoid tissue.
Source: Kumar et al: Robbins Basic Pathology Book 8E
Lymphoma
Hodgkin’s lymphoma Non-Hodgkin’s lymphoma
Nodular lymphocyte-predominant
Hodgkin’s lymphoma
Classical Hodgkin’s lymphoma:
Nodular sclerosis HL
Lymphocyte-rich HL
Mixed cellularity HL
Lymphocyte- depleted HL
B cell lymphomas T/NK cell lymphomas
Precursor B celllymphoma
Mature B celllymphoma
Precursor T celllymphoma
Mature T/NK celllymphoma
The WHO classification (2001)
Source: World Health Organization (WHO)
Non-Hodgkin Lymphoma Hodgkin Lymphoma
More frequent involvement of multiple peripheral nodes
More often localized to a single axial group of nodes (cervical, mediastinal, para-aortic)
Noncontiguous spread Orderly spread by contiguity
Mesenteric nodes and Waldeyer ring commonly involved
Mesenteric nodes and Waldeyer ring rarely involved
Extranodal involvement common Extranodal involvement uncommon
Table 12-10. Clinical Differences Between Hodgkin and Non-Hodgkin Lymphomas
Source: Kumar et al: Robbins Basic Pathology Book 8E
Classification
• Age: The disease peaks at ages 15 to 40 and at 55 and older.• Exposure to environmental poisons, such as Agent Orange • Family history of the disease, although lymphoma has only a weak genetic
link• Gender: Hodgkin lymphoma is more common in males than females• History of infectious mononucleosis or Epstein-Barr virus• Prolonged use of human growth hormone • Weakened immune system, including infection with HIV
Source: http://www.kucancercenter.org/cancer-information/specialties-and-treatment/lymphoma/prevention
RF - Hodgkin Lymphoma
• Age: The likelihood of getting NHL increases as you get older. • Bacterial infection: Infection with Helicobacter pylori increases the risk of
lymphoma involving the stomach. • Gender: Non-Hodgkin lymphoma is more common in males than females.• Exposure to farming chemicals or fertilizers, chemicals used to dissolve
rubbers or glues, chemicals used to make rubber products, asbestos and arsenic increases the risk of developing NHL. • Weakened immune system: NHL is most common among those who have an
impaired immune system or a severe autoimmune disease. It also occurs among those who take medicines to suppress the immune system following an organ transplant. • Viral infection: Infection with Epstein-Barr virus or Human Immunodeficiency
Virus (HIV) increases the risk of developing NHL.
RF – Non-Hodgkin Lymphoma
Source: http://www.kucancercenter.org/cancer-information/specialties-and-treatment/lymphoma/prevention
Source: http://emedicine.medscape.com/article/201886-overview#aw2aab6b2b3
Etiology - Hodgkin Lymphoma
• EBV, may be involved in the pathogenesis. In as many as 50% of cases, the tumor cells are EBV-positive.
• Patients with HIV infection have a higher incidence of Hodgkin lymphoma compared with the population without HIV infection.
Infectious agents
• Approximately 1% of patients with Hodgkin lymphoma have a family history of the disease.
Genetic predisposition
• May have a protective effect against lymphomagenesis through mechanisms that may be independent of vitamin D
UV radiation exposure
Source: http://emedicine.medscape.com/article/201886-overview#aw2aab6b2b3
Etiology – Non-Hodgkin Lymphoma
• Epstein-Barr virus (EBV), Human T-cell leukemia virus type 1 (HTLV-1) , Hepatitis C virus (HCV), Kaposi sarcoma–associated herpesvirus (KSHV) , Helicobacter pylori infection.
Infectious agents
• The t(14;18)(q32;q21) translocation is the most common chromosomal abnormality associated with NHL.Chromosomal translocations
• chemicals (eg, pesticides, herbicides, solvents, organic chemicals, wood preservatives, dusts, hair dye), chemotherapy, and radiation exposure.
Environmental factors
• Congenital immunodeficiency states, AIDS, Celiac disease.Immunodeficiency states
• Sjögren syndrome and Hashimoto thyroiditis.Chronic inflammation
Etiology – Q
Which of these agents will not cause HL?• HIV Infection• Genetic predisposition• UV radiation• Non of the above
• Data taken from SEER (Surveillance Epidemiology and End Results) http://seer.cancer.gov• Prevelance includes any person alive on January 1, 2009
who had been diagnosed with lymphoma at any point prior to January 1, 2009 and includes persons with active disease and those who are cured of their disease.
Prevalence – World Wide
1- Non-Hodgkin Lymphoma 2- Hodgkin Lymphoma
Non-Hodgkin Lymphoma On January 1, 2009 , in US
Source: Surveillance Epidemiology and End Results (SEER) http://seer.cancer.gov/statfacts/html/nhl.html
Prevalence – World Wide
1- Non-Hodgkin Lymphoma: 484,336
252,111 men 232,225 women
Prevalence – World Wide
Source: Surveillance Epidemiology and End Results (SEER) http://seer.cancer.gov/statfacts/html/nhl.html
Hodgkin Lymphoma On January 1, 2009 , in US
2- Hodgkin Lymphoma: 174,908
90,425 men 84,483 women
Prevalence – World Wide
Which is More common?
Or
Hodgkin Non-Hodgkin
Source: Harrison’s Principles of Internal Medicine 17th edition
Figure: Relative Frequency of Lymphoid Malignancies
Prevalence – Saudi Arabia
Source: http://www.rightdiagnosis.com/n/non_hodgkins_lymphoma/stats-country.htm
Prevalence – Saudi Arabia
Prevalence – Saudi Arabia
Source: http://www.rightdiagnosis.com/n/non_hodgkins_lymphoma/stats-country.htm
://http . . . / /1503/15_3_2009_0600_0611.applications emro who int emhj pdf Source: WHO
Prevalence – Saudi Arabia